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NPI Code Detail

MEDICARE: MS. DARLENE FRASER LMFT

MEDICARE: MS. DARLENE FRASER LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist38481CA

General Provider Information

NPI Number : 1275751331
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DARLENE FRASER LMFT
Provider Business Mailing Address
First Line : 3200 ADELINE ST
Second Line :
City : BERKELEY
State : CA
Zip : 94703-2407
Country : US
Telephone Number : 510-601-0203
Fax Number : 510-601-4002
Provider Business Practice Location Address
First Line : 3200 ADELINE ST
Second Line :
City : BERKELEY
State : CA
Zip : 94703-2407
Country : US
Telephone Number : 510-601-0203
Fax Number : 510-601-4002
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2007
Last Update Date : 07/08/2007

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